Method of applying a medical dressing device

ABSTRACT

A method of applying a wound management dressing device. A foamed polyurethane pad of a selected size and having a hydrophilic side for contact with a wound and a hydrophobic side for facing away from the wound is positioned on a porous non-woven fibrous sheet of a larger selected size and having an adhesive on the side contacting the hydrophobic side of said pad so that the device presents the hydrophilic side and the adhesive for use in contact with the wound. A non-sticking removable cover is placed over the adhesive side of the sheet to prevent early exposure of the pad and the adhesive.

This a continuation application of pending Ser. No. 022,863, filed03/06/87 entitled MEDICAL DRESSING DEVICE, which is a continuation ofSer. No. 902,667, filed 09/02/86 entitled MEDICAL DRESSING DEVICE, nowAbandoned.

FIELD OF THE INVENTION

This invention relates to a medical dressing device useful in treatingburns, abrasions, lacerations and surgical incisions in which healing ofthe wound is promoted.

BACKGROUND OF THE INVENTION

Prior art dressings which were applied for wound management have beendressings which ere adapted for wound management rather than designedfor such treatment. Normally, standard dressings such as the most commonbandages made from gauze and adhesive tape, require changing frequently.One to two days is a long period of time for treating a wound with asingle medical dressing or bandage. Accordingly, frequent changing evenof inexpensive dressings significantly increases patient cost, both fromthe large number of bandages required and for the hospital personnelneeded to change the dressing.

One form of urethane foam which has been applied as a dressing forvarious wounds is the Duo-DERM® dressing, which is a registeredtrademark of ConvaTec, a Squibb company. This urethane has an acrylicadhesive coating and negative reactions have been noted from contact ofwounds with the adhesive. Additionally, the adhesive may tend tomascerate the wound. Johnson & Johnson's Ulcer Dressing also has beenproposed for various wounds, but it, too, has an adhesive facing whichinterferes with the healing process.

What has not been available until the present time is a wound dressingmaterial designed specifically for wound management. This dressingshould be suitable for a wide range of wounds including burns,abrasions, lacerations, pressure sores, leg ulcers and both skin graftdonor and recipient sites.

An ideal wound management dressing is one which is non-adherent,permeable to water vapor, carbon dioxide and oxygen. The dressing shouldalso be capable of creating a micro-environment which the wounds moistand near the physiologic temperature.

SUMMARY OF THE INVENTION

It has now been discovered that a superior wound management dressing maybe prepared and wounds treated using the wound management dressingdevice to achieve significant improvement in the quality and rate ofhealing in most, if not all, categories of wounds. Specifically, a woundmanagement dressing device has been discovered which includes apolyurethane foamed pad of a selected size and having a hydrophilic sidefor contact with the patient and a hydrophobic side for facing away fromthe patient. Also included is a porous non-woven, fibrous sheet of alarger selected size, having an adhesive on one side. The adhesive sideis positioned against the hydrophobic side of the pad so as to presentthe hydrophilic side and the adhesive for contact with a patient. Theselected size is, of course, appropriate to present the pad to the woundand to prevent contact of the adhesive with the wound being treated.Finally, a non-sticking removable cover may be placed over the adhesiveside of the sheet, the cover being removable to expose the pad and theadhesive upon use.

Also contemplated in this invention is a method of treating wounds suchas burns, abrasions, lacerations and surgical incisions. The methodincludes the steps of cleaning the wound, applying a wound managementdresssing of the type described herein and maintaining the dressing incontact with the wound for up to five to seven days.

Preferred urethane foam pads range in thickness from 0.50 to 1.50 mm.The porous, non-woven fibrous sheet is formed from non-woven fibers, andpreferred fibers are polyester fibers. Kendall Corporation manufacturesa polyester monomer material under the trademark NOVENETTE®. Normalpermeability of the fibrous sheet is at least 173 cc/hr.

In order to promote healing and reduce pain, it is desirable that thewound management dressing device be sterilized. The pad may besterilized by irradiation, such as by using cobalt 60.

A non-sticking removable cover may be placed over the adhesive side ofthe sheet to prevent premature exposure of the pad and the adhesive. Aconventional plow design non-sticking cover may be employed.

BRIEF DESCRIPTION OF THE DRAWINGS

These and other objects of the present invention and the variousfeatures and details of the operation and construction thereof arehereinafter more fully set forth with reference to the accompanyingdrawings, wherein:

FIG. 1 is a schematic view showing a preferred embodiment of the presentinvention prior to application on a wound;

FIG. 2 is a schematic drawing showing the application of the woundmanagement dressing device on a wound for treatment; and

FIG. 3 is an enlarged view of a portion of the covered wound shown inFIG. 2, taken at line 3--3.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT

As shown in FIG. 1, the wound management dressing device of thisinvention is pictured in a partially opened position ready forapplication, after having been taken out of any sterile packaging whichmight be needed to maintain the dressing device in a ready-to-usesterile condition. A polyurethane foam pad 11 of a selected size isshown having a hydrophlic side on the top for contacting with thepatient. A hydrophobic side is in the reverse side facing away from thereference numeral on the drawing. The hydrophobic side of thepolyurethane foamed pad 11 is in contact with a porous non-woven fibroussheet 13 of a larger selected size. The sheet 13 is designed to belarger than the pad 11 and is particularly required to be porous. Anon-sticking removable cover 14 and 15 is placed over the sheet. Thisdesign shown in FIG. 1 is the conventional plow of a two-piece,non-sticking removable cover which is designed to be easily removed bypulling the tab portion of the side 14 and curling away the otherportion 15 of the cover. An adhesive 117 is placed on the entire side ofthe sheet 13, holding the foam 11 in place as well as fastening thecovers 14 and 15 into place. Because of the non-sticking feature of thecovers 14 and 15, they are easily removed from the adhesive.

As is indicated above, the primary functioning element is a polyurethanefoamed pad which has a hydrophilic side of contact with the patient anda hydrophobic side for facing away from the patient. The pad isnon-adherent and is permeable to water vapor, carbon dioxide and oxygen.It creates a micro-environment which keeps the wound moist and near thephysiologic temperature. The foam has been sterilized and is preferablysterilized by irradiation, such as by the use of cobalt 60 irradiationwhich not only sterilizes the foam pad, but also alters the color,darkening it to a closer to skin color. This foam pad is ideal for awide range of wounds including burns, abrasions, lacerations, pressuresores, leg ulcers and both skin graft donor and recipient sites.

The pad 11 is supported on a porous, non-woven fibrous sheet 13 sized topermit application of the pad to the wound and having an adhesive 17 onthe side bonding the pad to the sheet. The particular sheet employedshould have a permeability of at least 175 cc/hr, and preferably between150 cc/hr and 200 cc/hr. The sheet is formed from non-woven, fiberswhich are inert to the body, preferably from polyester non-woven fibers.NOVENETTE® brand polyester fibers manufactured by the KendallCorporation are preferred. The adhesive 17 which is employed may be anyof the conventional acrylic adhesives which are inert at least toundamaged skin. Other conventional pharmaceutical adhesives may also beused.

As shown in FIG. 2, the pad 11 and sheet 13 are in place on a patient'sarm 10 which has a severe wound. The wound may be any of a wide range ofwounds, including burns, abrasions, pressure sores, leg ulcers and bothskin graft donor and recipient sites. An enlarged portion of FIG. 2 isshown in FIG. 3 where the wound 12 is covered by the foam pad 11 and isheld in place by a sheet 13. Because the foam pad 11 is hydrophilic onthe side adjacent the wound 12, exudate will flow in the direction ofthe solid arrows from the wound through the foam into the porous sheet13. Oxygen can reach the wound D, as shown by the dash-line arrows, toaid in healing. The pad 11 thus acts as a thermo-insulator, offeringprotection against secondary infection, and maintaining an environmentwhich allows for prompt healing. The physiologic temperature ismaintained by the pad, which increases cell division, optimizesphagocytosis, and prevents eschar formation. This generates faster andless painful healing.

Products of the present invention as described herein have been testedin comparison with standard bandage treatments, with results showing asignificant improvement in the quality and rate of healing in allcategories of wounds.

Surpisingly, pain is also significantly reduced, as the nerve endingsare covered.

A study was performed of two hundred patients which were treated at anemergency department in a hospital. Eighty patients had partialthickness burns. Seventy patients had deep abrasions. Fifty patients hadlacerations. Half of each of the sub-groups were treated with standardtherapy as controls. The other half were treated with the presentinvention.

All the patients treated with the wound management dressing device ofthis invention showed statistically significant faster healing. Thewounds looked different because of the removal of the exudate so thatthe underlying skin once the exudate has been removed, such as with warmsaline solution, reveals a beautifully healing epithelium underneath.Scarring was significantly reduced.

The dresssing of the present invention requires changing only once everyfive to seven days as opposed to every one to two days with manystandard dressings. Accordingly, there is better patient compliance,more convenience for the staff and reduced cost. All of these benefitsare of great value.

In using the wound management dressing device of the present invention,the following dressing technique is recommended. The wound is firstcleansed and it is valuable to lightly debride loose eschar and necrotictissue. The dressing size is selected to allow at least a 2 cm overlapat the wound edge in order to avoid leakage of exudate and loss of woundenvironment. The dressing may be trimmed as desired.

It is advisable to cleanse the wound with a warm isotonic (0.9%) salinesolution. Strong antiseptics have been known to cause cell necrosis andshould be avoided. The outer non-sticking removable cover is removed andthe hydrophilic side facing up from the pad is placed in contact withthe wound, ensuring at least 2 cm overlap at the wound edge. It isdesirable to avoid excess overlap as exudate may irritate healthy skin.A slight tension is applied to eliminate air pockets and to provide anintimate wrinkle-free contact with the wound surface. The overlyingporous, non-woven fibrous sheet is then pressed onto the non-woundedportion of the patient's skin to adhere the product to the patient.

The wound dressing may remain in place for five to seven days, endingupon the amount of exudate which is present. At changing, the dressingmay be removed in the traditional manner. Typically, there is noadherence between the wound and the dressing.

While a particular embodiment of the invention has been illustrated anddescribed herein, it is not intended to limit the invention and changesand modifications may be made therein within the scope of the followingclaims.

What is claimed is:
 1. A method of treating wounds such as burns,abrasions, lacerations and surgical incision, comprising the stepsof:cleaning said wound; applying to said wound a foam pad consistingessentially of polyurethane having a thickness ranging from 0.50 to 15.0mm and sized to cover said wound and extending at least two cm beyondthe wound edge, said pad having a hydrophilic side in contact with saidwound, and a porous, non-woven fibrous sheet having a permeability towater vapor, carbon dioxide and oxygen of at least 175 cc/hour and sizedlarger than said pad size and having an adhesive side in contact withthe pad, said sheet then being pressed on to the non-wounded portion ofthe patient's skin to adhere the product to the patient; and maintainingsaid pad in contact with said wound for five to seven days.